In many materials-handling applications, automated storage and retrieval systems are utilized to store and retrieve objects. Some systems are designed to retrieve singular objects from bins containing a multiplicity of objects, such as a system supporting an automated assembly line, wherein the storage and retrieval system might have a plurality of bins, each bin containing a multiplicity of a particular size of fastener.
Medications in the form of solid pharmaceuticals such as pills, capsules, tablets, and the like are traditionally provided in the form of a disposable plastic container having the medication name, dosage and provider printed on the label. The term medicament is used herein to refer to a solid medication in the form of a pill, for example, a tablet and a capsule. Patients taking a plurality of prescription medications, frequently exhibit poor compliance in properly following a particular drug regimen. It is typical for the medications to be taken in varying dosages, on various days, and times. Geriatric patients, particularly those having impaired eyesight, mental acuity and other cognitive, motor, or sensory dysfunctions are a leading group who make medication mistakes resulting in missed medications, errors in intervals or improper dosages. Even people with intact function often have difficulty maintaining medication regimen adherence, especially when they are prescribed multiple chronic medications. A variety of products and techniques for reminding patients of their medication regimens are known, however, to date have had limited success as a result of cost, reliability, complexity, inadequate utility and lack of “fail-safe” operation.
In the various embodiments described herein, it is important that the retrieval system retrieve and deliver a precise quantity of the desired objects or objects. Frequently the desired quantity of objects is one. Quantity precision for quantities larger than one object can be obtained by multiple retrievals of singular objects.
Additionally, in the embodiments described herein, a user friendly design is important. Using a vacuum probe for the pick and place system can improve the design, for example by permitting the use of the vacuum pressure as an indication of the successful pick or retrieval of an object or item such as solid medicaments. The use of a carousel design, with a plurality of bins or containers placed in a side-by-side relationship around the carousel permits the storage, and retrieval, of a plurality of object types or medicaments, and makes the disclosed embodiments appropriate for dispensing medication for personal use. Furthermore, the use of open-top containers, as disclosed in embodiments herein, significantly improves the ease of loading, reloading and refilling the containers with items such as pills, and also allows the retrieval probe to be moved laterally within the container to interrupt bridging and to “search” for items to be retrieved from the container.
In the various embodiments described herein, it is also important that the correct object is retrieved. Identification of the object and confirmation that the object is correct is particularly of concern if the bulk compartment could be loaded improperly. Thus, confirmation that the bulk compartment was loaded with the correct objects or confirmation that the correct object is retrieved is a possible feature of the disclosed embodiment. Identification of the object can be performed by acquiring at least one picture or digital image of the object and using image recognition computer algorithms that extract various characteristics of the object and compare those to a reference database containing identifying information about the objects. The image may also be stored or logged as a record of the medicament that is retrieved and dispensed.
In the health care industry, automated and manual dispensing devices have been used to segregate, and control the dispensing of a wide range of medicaments, such as pills, vials, and packets, to ensure that the prescribed dosage is administered at the intended time interval. An example of a dispensing system is disclosed, for example, in U.S. Pat. No. 7,502,664 (issued Mar. 10, 2009) and U.S. Pat. No. 7,587,259 (issued Sep. 8, 2009) both by M. Berg; the entire contents of said patents being hereby incorporated by reference for their teachings.
Additionally, refills, expiration and pill inventory are supplemental features of an automated dispensing system. Generally speaking assisted pill dispensing of a prescribed dosage of a plurality of pills have customarily been manually prepared in partitions within a pill containment tray or case, whereby an associated alarm device or clock advises the patient or care giver that it is time to consume the next compartment of medications. Alternatively, a pharmacy may package a prescription in a “blister pack” or other specialized packaging, which is engaged into a dispensing mechanism that retrieves each pill on a pre-programmed basis. Programmable dispensing devices for in-home use are also known.
Presently, there exists a need for a system that provides an effective solution for both patients and health care providers regarding the patient's adherence to medication and dosage regimens. Such a system should enhance the interaction between the patient and health care provider by reliably dispensing medications for patient use, while allowing the health care provider to monitor the medication intake and program the medication regimen. Such a system should also provide a “recovery” or restocking process, including the ability to recycle medications that were not taken on time, so that medications are not wasted when a patient fails to retrieve medication.
A common method for retrieving small objects from storage bins is to utilize a vacuum probe with tip, associated with a retrieval mechanism. When the probe is connected to a vacuum pump, or other vacuum source, an inrush of air occurs creating a pressure differential that in turn acts on objects in proximity to the probe tip. The pressure differential urges the objects toward the probe tip until the object obstructs the opening of the probe tip, creating a vacuum force that holds the object onto the tip, which in turn allows the retrieval mechanism to lift the object. The vacuum probe can be said to have gripped or grasped the object by the application of the vacuum pressure.
Although primarily discussed herein as a system and method designed to “grip” and retrieve solid pharmaceuticals, it will be appreciated that aspects of the disclosed embodiments may employ alternative gripping or retrieval mechanisms. For example, when a storage bin holds magnetic objects (e.g., ferrous objects such as steel screws), the retrieval mechanism may employ a magnetic tip. With such retrieval methods, it is also conceivable that the retrieval mechanism may, in fact, lift more than a single object from the bin or container in which it is stored. To prevent or reduce the probability of a multi-object retrieval in accordance with the disclosed embodiments, an apparatus suitable for singulating objects, or a “singulator,” may be employed to assure that only a single object is removed or dispensed at a time.
One example of a singulator that may be employed with embodiments disclosed herein is an aperture through which the object must be retrieved, where the aperture is variably or dynamically sized to permit only a single object to be retrieved—thereby only allowing a single object through the aperture. As will be appreciated based upon the detailed description below, the retrieval probe and tip must be made small enough to pass through the aperture while retaining the at least one object or object. For objects smaller than the probe and tip, the aperture may be adjusted to allow the probe and tip to pass through the aperture orifice and then the size of the aperture can be decreased to permit only one object to pass through.
When retrieving objects which may have a primary dimension significantly greater than others, such as machine screws, where the length often is much greater than the diameter, or such as pharmaceutical caplets or capsules, where the length may exceed the diameter(s), the required restrictive aperture may often be smaller than the length dimension of the object being retrieved. If the object is attracted to the tip of the retrieval probe (e.g., with the long side of the object making contact with the tip), it would be impossible for the object to be retrieved through an aperture smaller than the long dimension of the object. In practice, it is observed that if the attractive force between the tip and object being retrieved is sufficient, the object may actually reorient itself relative to the retriever probe tip, for example when the restrictive aperture is encountered by the object, as the retrieval mechanism attempts to move the object through the aperture. The reoriented object may, therefore, present a smaller dimension, cross-section or less-restrictive profile/shape to the aperture, and may successfully pass through the aperture. Tapering the surfaces surrounding the aperture opening, for example as a cone-shape tapered in a direction toward the aperture opening, increases the probability that the object will successfully reorient itself.
While a bin top with a fixed aperture reduces the probability of multi-object retrieval for objects of a common size, it requires that the aperture size be matched to the objects to be retrieved therethrough. Such an aperture, however, does not necessarily prevent a second object from following a first object through the aperture. Furthermore, it requires predetermination of the appropriate aperture size for the objects stored in each storage bin. An aperture with a variable orifice with dynamic controls is disclosed herein in association with a method to singulate objects.
Another example of a singulator disclosed herein is a digital image capture apparatus and associated image processing circuitry by which a plurality of images of the retrieved object(s) is analyzed to determine whether a single or multiple objects have been retrieved. An image-based singulation apparatus may further enable the characterization and/or verification of the object type to assure that an appropriate medication (e.g., pill type) has been retrieved for dispensing. Furthermore, the use of a plurality of singulation techniques, in combination, is also contemplated.
For restocking of storage bins fitted with fixed or removable tops the top would have to be removed to allow new content to be added into the bins, and would further require that a correct top be placed back onto that bin. In embodiments disclosed herein the possibility of an error restocking the bins by loading them with an incorrect object is contemplated. Imaging techniques, as noted above, and associated image recognition may also be used to identify such an error before the incorrect object is dispensed.
One embodiment disclosed herein provides a system that includes a dispensing apparatus having a number of storage containers, each of which may contain a different object, an associated temporary or pre-dispense storage container for receiving the different objects retrieved from storage containers, and a delivery tray or cup for receiving and then dispensing the various objects such as solid medicaments. The device further assures singulation of retrieved objects and thereby dispensing of an accurate dosage. An advantage of such a device is that it reliably dispenses the correct dosage level by avoiding an errant pill or the like from passing into the delivery tray or cup. Moreover the dispensing information is recorded or logged and stored in a memory for subsequent use.
Another embodiment disclosed herein provides for reduced overall height of the device with use of a flexible or angled vacuum probe. In one embodiment the flexible vacuum probe can be guided around a radiused angle, such as a ninety degree turn, by: a surrounding fixed sheath forming a channel, a set of pulleys and guides, a set of grooved wheels and guides, or similar components and combinations thereof. Similarly, the disclosed embodiments contemplate the ability to control the position of the vacuum probe relative to a storage container or bin, and thereby facilitate the probe being guided to a specific location in the storage bin to pick up the objects.
As noted above, the use of image-based singulation further provides for the reliable identification of the medication to ensure that the proper medication was retrieved and loaded into the pre-dispense storage compartment and subsequently dispensed to a patient. The system can further store such information to permit the patient, care giver, or other health care provider to verify that the proper medication was loaded. Although the term identification has been employed to represent a visual identification in many of the disclosed embodiments discussed and described below, it is intended that identification may be accomplished or aided by characterization of objects to be dispensed in a way other than complete visual identification, for example the shape, size, color and markings on an object may be used to complete identification by using such information as “indices” into a database that includes a cross-reference of the characteristics against a unique ID (e.g., National Drug Code (NDC), name, number, etc.) for the object. Hence the term, “identification”, unless otherwise apparent from the context, should be broadly read to include not only visual identification, but may include additional characteristics such as weight, spectroscopy, human visual confirmation, etc.
Operative elements of the disclosed pill dispensing system include a microprocessor, motor(s), a pill retrieval probe, probe tip or proboscis-like element, pill receptacles and an apparatus for the singulation of pills or similar objects being dispensed. More specifically, a retrieval system with a vacuum probe (‘pick and place’ system) selectively moves a single object or unit of a medicine from one of a plurality of storage receptacles, and then stores the object, along with others, in a temporary storage or pre-dispense container before the used retrieves the collected medications.
Also contemplated in accordance with the disclosed system is a communications interface and protocol, associated with the dispensing apparatus, for on-site and/or remote control of the operation and functionality of the dispensing system. Remote programming can be enabled for the medication regimen which can include adjustments for late or missed doses, and schedules that reduce or increase, over a programmed time period, the number and frequency of objects being dispensed from the apparatus as in a medication titration. Furthermore, a missed dose may be restocked, as needed medications can be programmed with constraints, and allowances can be made to get medication doses early or to get extra doses if a pill or pills are damaged or lost. In addition object (e.g. pill) inventory can be performed by retrieving a programmed number of doses or objects and placing these into the pre-dispense compartment and then restocking the objects once a specified count is reached or the bulk storage compartment is empty (i.e. no further objects can be retrieved from the bulk storage compartment by the vacuum probe and retrieval system). All the information regarding device function including object supply, retrieval, orifice sizes and function, dispensing, restocking, inventory and device errors or malfunctions can be stored within a memory associated with the system and retrieved and/or viewed by appropriate authorized personnel including the health care provider.
Operative elements of the disclosed pill dispensing system also include a pill identification system that incorporates an imaging system or camera(s), light source(s) for appropriate lighting during imaging, possibly mirror(s) for multiple views with a single camera, and an imaging region, area, or compartment, along with a microprocessor with storage for performing the image processing algorithm and accessing a database.
Accordingly, it is an object of the disclosed system and methods to accurately dispense variable medication doses at various times.
Similarly, it is an object of the disclosed system and methods to accurately identify a wide variety of objects including medications with a wide spectrum of shapes, colors, sizes, and markings.
Disclosed in embodiments herein is an object dispensing system, including: a housing comprising a rotatable carousel, the rotatable carousel including a plurality of removable containers where each container provides a repository for objects therein; an access port in the housing through which an object may be removed from each of the plurality of containers, in seriatim; a pre-dispense port in the housing providing controlled access to one of a plurality of output containers (a dispense container and a restocking container); and a retrieval probe, said probe located within the confines of the housing and operatively moving (laterally sliding/swinging) between the access port and the pre-dispense port, said probe including a compliant tip for releasably engaging an object in one of the plurality of containers via said access port, said probe retrieving the object from a container and then moving between the access port and the pre-dispense port to deliver the object to a dispensing receptacle.
Also disclosed in embodiments herein is a medicament dispensing method comprising: providing a dispensing system, including a housing having a rotatable carousel therein with a plurality of removable open-top containers, where the carousel moves under the control of a carousel drive, each container including a repository for objects therein; an access port in the housing through which an object may be removed from the plurality of containers, in seriatim; a pre-dispense port in the housing providing controlled access to one of a plurality of output containers; and a retrieval probe, said probe located within the housing and operatively movable under the control of a horizontal slide drive by a slide motor between the access port and the pre-dispense port, said probe further including a vertical slide retracting and extending the probe and a compliant tip thereon under control of a vertical slide motor, the probe tip releasably engaging an object in one of the plurality of containers via the access port, placing a different medicament into at least two of the plurality of containers; in response to a dispense request, a controller operating to move the carousel to place a container having the requested medicament beneath the access port, and moving the horizontal probe slide into a position so that the probe tip is over the access port, wherein the probe is then extended to engage a medicament, and once engaged by the probe tip, the medicament is raised while attached to the probe tip and retrieved from the container via the access port; said controller then engaging the horizontal slide drive to cause the horizontal probe slide to move into a position over the pre-dispense port; releasing the medicament from the probe tip to deliver the medicament to a pre-dispense receptacle beneath the pre-dispense port; and moving the pre-dispense receptacle, using a pre-dispense slide motor responsive to the controller, to transfer the medicament from the pre-dispense receptacle to a dispense cup accessible by a user
In addition, disclosed in embodiments herein is a medicament dispensing system, comprising: a housing comprising a rotatable carousel, the rotatable carousel including a plurality of open-top, removable containers where each container provides a repository for medicaments therein; an access port in the housing through which an object may be removed from each of the plurality of containers, in seriatim; a pre-dispense port in the housing providing controlled access to one of a plurality of output containers; a hollow retrieval probe connected to a controllable vacuum source to provide a vacuum tip at one end that releasably engages the medicament for removal from the container using the vacuum to attach the medicament, wherein said probe retracts upon drawing a vacuum at the tip by contacting at least one medicament and where said probe located within the confines of the housing and operatively moving between the access port and the pre-dispense port, said probe including a compliant tip for releasably engaging an medicament in one of the plurality of containers via said access port, said probe retrieving the medicament from a container and then moving between the access port and the pre-dispense port to deliver the medicament to a dispensing receptacle; a singulator, operatively interposed adjacent the access port, said singulator operating to assure that only a single medicament object is removed at a time by the retrieval probe, wherein the singulator is selected from the group consisting of an imaging capturing device; an iris-type variable orifice, and a variable orifice formed between a pair of rollers each having a cam-shaped recess thereon; a first movable cover associated with both the access port and pre-dispense port; a second movable cover associated with each of the plurality of containers supported by the carousel, wherein the first and second movable covers are operatively engaged to seal the containers and access port and prevent an medicament from being removed from the container when the system is not in operation, wherein the first and second movable covers are operatively connected via a single mechanism employed to coincidentally control the engagement and disengagement of both the first and second covers; a processor enclosed within the housing, said processor controlling the operation of the carousel and the retrieval probe to assure that a medicament in a selected container is retrieved and dispensed by the system; a re-stock receptacle to receive any non-dispensed items, said restock receptacle storing the items until a manual intervention results in the items being restocked in an appropriate bin; and a database, stored in memory, for tracking those items that are placed into the restock bin and decrementing the items from a supply of available items, also reflected in the database, until such time as the items are restocked into a respective container.
The various embodiments described herein are not intended to limit the disclosure to those embodiments described. On the contrary, the intent is to cover all alternatives, modifications, and equivalents as may be included within the spirit and scope of the various embodiments and equivalents thereof.